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Ongoing treatment with anti-vascular endothelial growth factor (VEGF) injections or photodynamic therapy (verteporfin) is, to date, the primary means of managing and treating AMD. Several non-profit organizations also offer patient access programs.
Here is a brief description of some of the patient-assistance programs (PAPs) specific to retinal disorders/AMD. Other resources are available from organizations other than the pharmaceutical company:
Beginning in 2017, the HealthWell Foundation (https://www.healthwellfoundation.org/) launched a Macular Degeneration Fund to provide copayment and premium assistance to eligible patients living with macular degeneration. Under the fund, HealthWell provides up to $4,000 to individuals who have annual household incomes up to 400% of the Federal Poverty Level (FPL) to assist with out-of-pocket costs for treatment of their disease. (Of potential note, this fund also covers off-label intravitreal bevacizumab.) Eligibility criteria includes being currently treated for AMD (wet or dry), insurance that covers medication, income falling within the stated parameters, and receiving treatment in the United States.
MyGoodDays (https://www.mygooddays.org) provides financial support by “covering prohibitively costly co-pays for those with life-altering conditions, allowing them to receive treatment without destroying their finances.” The group may additional financial assistance for health insurance premiums and treatment-related travel expenses. This group covers all macular diseases, including AMD, cystoid macular edema, diabetic macular edema, myopic choroidal neovascularization, and vitreomacular adhesion. To be eligible, patients must have a valid Social Security number, valid Medicare or military insurance coverage, income level at or below 500% of the FPL, and receive treatment in the United States. Assistance is up to $4,200.
Prevent Blindness (http://www.preventblindness.org) provides a financial assistance directory in both English and Spanish, and lists contact information for numerous organizations that act as patient advocates. For retinal diseases, these include the American Academy of Ophthalmology’s EyeCare America Program, Association of Schools and Colleges of Optometry, Genentech Access Solutions, the Hill Burton Program, Lions Club International, Lucentis Access Solutions, NeedyMeds, National Federation of the Blind, Partnership for Prescription Assistance, among others. Its Living With AMD provides additional resources for patients.
The Patient Access Network (PAN) Foundation (www.panfoundation.org) offers assistance ($2,300 per year, but patients may apply for a second grant during their eligibility period subject to availability of funding) with copayments related to treatment for macular diseases. To be eligible, patients must have a valid Social Security number, valid Medicare or military insurance coverage, income level at or below 500% of the FPL, and receive treatment in the United States or in U.S. territories. Citizenship is not a requirement.
All three pharmaceutical manufacturers (Bausch + Lomb, Genentech, and Regeneron) offer some form of financial assistance program for eligible patients.
Lucentis Support Programs
The Lucentis Patient Support Program from Genentech is available for patients who have been diagnosed with wet AMD. Patients can enroll in the program for free and are provided access to a Lucentis Specialist who can answer questions about the drug and wet AMD in general, enroll patients in the Lucentis Patient Support Program, and connect patients to Lucentis financial assistance programs. Patients on the program also receive access to financial resources that can help with out-of-pocket costs and reimbursement support.
Bausch + Lomb
Patients on Macugen (pegaptinib) injections for the treatment of wet AMD may be eligible for the Focus on Access program from Bausch + Lomb. The Focus on Access program helps eligible patients secure access to Macugen. Patients may also receive reimbursement counseling.
Eylea Access from Regeneron
EYLEA4U from Regeneron provides patient support for Eylea injections. For patients with commercial insurance not funded through the U.S. government, EYLEA4U may be able to offset some out-of-pocket co-pay costs. For patients with insurance through a government healthcare program such as Medicare or Medicare Advantage, EYLEA4U can refer patients to an independent charitable foundation designed to help patients pay for medications. An EYLEA4U Specialist will not only refer patients to a charitable foundation, they will follow up with the foundation until a decision is made on the application. For patients without insurance or whose insurance does not cover Eylea injections, EYLEA4U may be able to provide the drug free of charge. Regeneron also offers patients the EYLEA Injection Co-Pay Card Program.